Clinical Nurse Specialists on the Night Shift

Area of Science:

• Nursing
• Healthcare Management
• Patient Safety

Background:

• Night-shift nurses often lack the experience and support of day-shift nurses.
• Limited access to specialized resources like clinical nurse specialists (CNSs) impacts night-shift care.
• This study addresses the need for enhanced support systems for night-shift nursing staff.

Purpose of the Study:

• To describe the implementation and roles of newly established night CNS positions.
• To evaluate the outcomes and impact of night CNS support on nursing practice and patient care.
• To provide evidence for the value of specialized nursing support during night shifts.

Main Methods:

• Night CNSs were implemented with flexible roles including proactive rounding, code response, education, and psychosocial support.
• A shared consultation log was utilized to meticulously document CNS activities and work effort.
• Data were collected from October 2017 to April 2019 to define the scope of the night CNS role.

Main Results:

• Over 6000 CNS encounters were recorded across 24 categories, with top consultations for policy/procedure, education, and clinical assistance.
• Night CNSs responded to 569 rapid responses/codes, demonstrating their critical role in acute situations.
• A 17% increase in event reporting on the night shift suggests improved safety awareness and reporting culture.

Conclusions:

• Night CNSs are crucial for compensating for novice nurse deficits in advanced assessment, directly impacting patient outcomes.
• Their presence facilitates immediate education and fosters professional development among night-shift nurses.
• Organizations should consider implementing night CNS roles or flexible scheduling to bolster night-shift support.